Effects of a Case Management Program on Self-Care Behaviors and Diabetic Retinopathy Clinical Signs among Elderly with Diabetic Retinopathy in Quality Elderly Clinic

Abstract

Effects of a Case Management Program on Self-Care Behaviors and Diabetic Retinopathy Clinical Signs among Elderly with Diabetic Retinopathy in Quality Elderly Clinic ABSTRACT : Diabetic retinopathy is a common complication of Diabetes Mellitus (DM), leading to blindness and impacts on quality of life of patients and families. This one-group, quasi-experimental study was conducted to examine the effects of a case management program applying Orem’s nursing system theory and social support for older people with diabetic retinopathy. Thirty subjects were participated in a 12-week case management program, which applied Orem’s nursing system theory. The program consisted of health education, health assessment, a clinical pathway, individual counseling, a home visit, telephone follow up, with assessment of self-care behavior. Hemoglobin A1C (HbA1C) levels, fasting plasma glucose (FPG) and blood pressure were assessed before and after the program. Each subject was interviewed by the researcher about general characteristics, self-care behaviors. Data were analyzed using paired t-test. After the intervention, the mean scores of self-care behaviors of the older people with diabetic retinopathy were significantly higher than those before the experiment at a p-value of< 0.001. FPG, Hemoglobin A1C (HbA1C) and systolic blood pressure were significantly lower than before the intervention at a p-value of < 0.001. Moreover, diabetic retinopathy was not worse 96.6%. The results support a case management program applying Orem’s nursing system theory and social support that improved self-care behaviors and those clinical signs. This intervention should be applied in Quality Elderly care clinic to promote health outcomes among elderly with other chronic diseases.